Coronavirus Disease 2019 (COVID-19) and the Heart—Is Heart Failure the Next Chapter? (JAMA, 27 July)
Increased risk for morbid and mortal complications in COVID
Pre existing cardiovascular diseases
Hypertension
Coronary artery disease
Heart failure
COVID causing heart disease
39 autopsy cases, died from COVID-19 pneumonia
Histopathologic evaluation did not meet criteria seen in acute myocarditis
Evidence of virus present in the heart in 24 of 39 patients (61.5%)
Of these 24, 16 (66.7%) patients had a high viral load
Evidence of active viral replication was also noted
Also increased activation of pro-inflammatory genes in the heart
Myocardial injury therefore possible by 2 mechanisms
In 100 recovering patients
Evaluated a mean of 71 days after confirmed COVID-19 diagnosis
Detectable troponin
Reduced left ventricular ejection fraction
Ischaemia
Pericardial involvement
Cardiomyopathy and heart failure related to COVID-19 may become evident
Potential ongoing morbidity of heart failure and other chronic cardiovascular complications
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